Revision Total Hip
Revision Total Hip – Acetabular Reconstruction
In hip revision surgery, MatriGraft® femoral head allografts can be used to manage bone loss in the acetabulum. Surgeons sculpt these allografts to fit the patient's specific bone defect, before securing them into place. Once implanted, the allograft acts as a scaffold to promote new bone growth, helping to restore the original anatomy. These allografts also provide a robust and stable support for the new acetabular implant, thereby improving the long-term outcome of the surgery by enhancing joint stability and function. MatriGraft can be used with your bone void filler of choice.
- This study assessed long-term outcomes of complex acetabular revisions, focusing on cases where at least 50% contact between allograft bone and the prosthetic cup was achieved. Results suggest that massive allograft reconstruction of the acetabulum can provide immediate and long-term stability for the prosthetic cup, and effectively restore bone stock.
- This study evaluated the outcomes of acetabular reconstruction using a KT plate with either bulk or morselised femoral head allografts. The researchers concluded that bulk femoral head allografts are necessary for achieving mechanically stable reconstruction for large acetabular bone defects.
Revision Total Hip – Pelvic Osteotomy
Pelvic osteotomy procedures, such as Pemberton or Periacetabular osteotomy, are often used in the treatment of hip dysplasia, a condition where the hip socket does not fully cover the ball portion of the upper thighbone. This results in an increased risk of hip dislocation. The use of a MatriGraft® allograft bone wedge can be a part of this surgical procedure, helping to reorient the hip socket for better coverage of the femoral head. MatriGraft can be used with your bone void filler of choice.
- This study discusses the challenges of treating severe hip dysplasia with hip arthroscopy. While periacetabular osteotomy is the conventional treatment, its invasive nature and lengthy recovery can deter patients. The authors propose a minimally invasive endoscopic technique involving allograft iliac bone grafting, which could reduce donor-side morbidity and make the procedure less invasive.
- This retrospective study evaluated the use of allograft bone wedges in Pemberton osteotomies for the treatment of acetabular dysplasia, finding substantial improvement in both acetabular and lateral migration indices post-surgery. The technique provided immediate graft stability and often eliminated the need for postoperative spica casting, thereby accelerating the rehabilitation process.
Revision Total Hip – Arthroplasty
In hip revision surgery, femoral head allografts can be used to manage bone loss in the acetabulum. Surgeons sculpt these allografts to fit the patient's specific bone defect, before securing them into place. Once implanted, the allograft acts as a scaffold to promote new bone growth, helping to restore the original anatomy. These allografts also provide a robust and stable support for the new acetabular implant, thereby improving the long-term outcome of the surgery by enhancing joint stability and function. MatriGraft can be used with your bone void filler of choice.
- This study assessed long-term outcomes of complex acetabular revisions, focusing on cases where at least 50% contact between allograft bone and the prosthetic cup was achieved. Results suggest that massive allograft reconstruction of the acetabulum can provide immediate and long-term stability for the prosthetic cup, and effectively restore bone stock.
- This study evaluated the outcomes of acetabular reconstruction using a KT plate with either bulk or morselised femoral head allografts. The researchers concluded that bulk femoral head allografts are necessary for achieving mechanically stable reconstruction for large acetabular bone defects.
- This study investigated the long-term outcomes of acetabular reconstruction using autogenous and allografts from the femoral head in complex total hip arthroplasty, and found these grafts performed well for the initial five to ten years but faced increased failure rates by an average of 16.5 years.
Periprosthetic Fracture
Periprosthetic fractures are fractures that occur around joint replacements. Onlay allograft struts can be used in the management of these challenging fractures, providing structural support to the fracture site, and aiding in the bone healing process.
- The study discusses cortical onlay strut allografting as an increasingly preferred method for treating periprosthetic femoral fractures around stable implants, given their ability to provide mechanical stability, enhance fracture healing, and potentially increase bone stock. Because of their similar elasticity modulus to host bone, these bone struts cause less stress shielding than other, more rigid, internal fixation methods and can be used alongside other treatment modalities such as plate fixation or with a long-stem prosthesis revision.
- The study investigates the treatment of periprosthetic femoral fractures around stable implants using cortical onlay strut allografts alone or in conjunction with a plate, revealing a high rate of fracture union, satisfactory alignment, and increased femoral bone stock. The authors conclude that cortical strut grafts should be routinely employed to augment fixation and healing of a periprosthetic femoral fracture given their dual mechanical and biological function.
- The study compares two surgical treatments for femoral periprosthetic fractures: plate fixation alone and plate fixation with a strut allograft. Findings indicate that patients treated with plate fixation and a strut allograft experienced better outcomes, including lower surgical failure rates and enhanced biological healing. Strut allograft augmentation provides additional mechanical stability and contributes to fracture healing via osteoconduction.
- The article reviews the use of cortical onlay strut allografts in periprosthetic femoral fractures. Despite the effectiveness of strut allografts in providing structural support and increasing bone stock, concerns such as regarding soft tissue damage, potential infection make their routine use controversial, hence the need for further comparative studies to determine the most effective treatment for PFF.
Osteonecrosis of the femoral head (ONFH)
Fibula allografting can be used to treat Osteonecrosis of the Femoral Head (ONFH) in its early stages, which, if left untreated, can cause severe hip dysfunction and may eventually lead to femoral head collapse and the need for total hip arthroplasty (THA). Fibular allografting involves taking a portion of the fibular shaft, and transplanting it into the necrotic area of the femoral head. This transplanted bone can provide structural support to the affected area.